Provider Demographics
NPI:1689059560
Name:OT THERAPEUTIC INTERVENTIONS PC
Entity Type:Organization
Organization Name:OT THERAPEUTIC INTERVENTIONS PC
Other - Org Name:THERAPEUTIC INTERVENTIONS
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SOTOMAYOR
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:207-488-9675
Mailing Address - Street 1:163 FULLER RD
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:ME
Mailing Address - Zip Code:04740-4115
Mailing Address - Country:US
Mailing Address - Phone:207-488-9675
Mailing Address - Fax:207-488-9079
Practice Address - Street 1:163 FULLER RD
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:ME
Practice Address - Zip Code:04740-4115
Practice Address - Country:US
Practice Address - Phone:207-488-9675
Practice Address - Fax:207-488-9079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-21
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT291174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty